Thought experiment time!
Suppose that Congress were to raise income tax rates across the board by X%. Coupled to this tax hike would be the introduction of a tax credit that would completely offset the tax increase, for which one need only provide proof of maintaining a health insurance policy that meets a certain set of standards to qualify.
Question 1: How is this functionally different from a tax ("penalty") imposed via the income tax system upon people who do not buy health insurance?
Question 2: If your answer to the above is that it is not different, then don't tax credits or deductions given for engaging in other behaviors (buying a house, having children) constitute an effective tax on not engaging in those behaviors?
My argument here is not that this is necessarily a good or bad thing. Simply that it is nothing new.
If you object to the state manipulating personal choices via the tax code, you've a great deal more to be upset about than health insurance. Of course, if you have kids and a mortgage, you have a considerable stake in the system and it is completely understandable that you might not object too strenuously.
Speaking as a person with a respectable income, no kids, and no mortgage, let me just say...you're welcome.
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Question 2: If your answer to the above is that it is not different, then don't tax credits or deductions given for engaging in other behaviors (buying a house, having children) constitute an effective tax on not engaging in those behaviors?
The mortgage interest deduction doesn't help society that much and isn't necessary. I'd have no trouble repealing it, although it really would need to be phased out, because millions of Americans have ordered their lives around it.
The tax credit for children is another matter. We need kids who will become productive, taxpaying adults to pay for all this shit. So to my kids, who will "asked" to pay for a whole lot of things, a whole lot of adults can say, you're welcome as well.
So...there are positive returns to society for having children (or at least, children that grow up to pay taxes.) I agree!
So if it makes sense to tax people for not having them, why not tax them for not having health insurance?
So if it makes sense to tax people for not having them, why not tax them for not having health insurance?
Because the government isn't taxing people for not having children, it is providing a small break for those who take on the responsibility of rearing children. Trust me on this -- the tax break I get for my kids is nothing compared to the costs I incur for feeding, clothing and educating them. It's not even close.
And you understand the difference between providing an incentive and levying a penalty.
If you're arguing that the government should treat everyone equally, I'd generally agree. In the real world, it never happens.
Of course the benefits you will enjoy from my the labor of my kids will be paid out in the equivalent of Turkish lira, but that's another discussion.
I think the difference between incentive and penalty is one of accounting, when the state is involved.
I don't think you have adequately addressed question 1. If there existed a tax incentive to have health insurance rather than a penalty for not having it, would that be functionally different or not? And why are dependent deductions or child tax credits qualitatively different? Whether they offset the costs of having kids or not isn't really the point. Depending on the cost of your insurance premiums, paying the penalty might make more sense financially, too.
Whether they offset the costs of having kids or not isn't really the point. Depending on the cost of your insurance premiums, paying the penalty might make more sense financially, too.
Give yourself a cigar, Brian. You just figured out Obamacare. It's designed to fail because the smart people will realize the fine is less than getting insurance and since you'd be able to buy insurance even with preexisting conditions, it will bankrupt the insurance industry. And then you have single payer.
More soon on your other points.
Whether they offset the costs of having kids or not isn't really the point.
Didn't say it was the point, although it matters to the extent that you see that the government isn't really driving behavior with the tax code in this case. What drives having children is a biological imperative to continue the species. My kids were born during the Clinton administration and trust me on this -- my wife and I weren't really thinking about the tax implications at the time. And we sure the hell weren't thinking about Ways and Means Committee chairman Bill Archer, either. ;)
As for question 1 -- at bottom, it's not functionally different. The larger issue with Obamacare is that it affects everyone. There isn't really an opt-out. That's a huge qualitative difference, no?
The question we face with Obamcare, as with all governmental depredations, is this: are you willing to cede this amount of control over your life to a government? We all need to think quite carefully about that.
I think your last question is a fair point and one that I take very seriously. I do think an argument can be made that absent some substantial state intervention, we effectively cede an awful lot of control to insurance companies, and I'm not convinced that is preferable. Libertarians have a huge blind spot to coercion from non-state entities.
I think single payer is probably the least awful system among those that actually exist. It works pretty well among our friends and neighbors.
It's the half measures that really worry me.
I think single payer is probably the least awful system among those that actually exist. It works pretty well among our friends and neighbors.
Ask a Canadian with a chronic condition about wait times for surgery. And remember that a permanent feature of the British press is the nearly daily story of some poor shlub dying because of neglect from the NHS.
Trust me on this -- you don't want to put all your faith in a single payer, especially if it won't pay, or slow walks the payment. Is that really a better system?
My father in law is a Canadian with several chronic conditions that would be either dead or bankrupt ( probably both) without the Canadian system. Seriously, this is not an abstraction to me.
I'm not saying that it is perfect. But if you deal in data rather than anecdotes, it works at least as well as our mess in the aggregate, and better in the lower income brackets.
Brian--well taken, but as a guy who's been to the ER a few times, once with a blocked bile duct and associated pancreatitis, suffice it to say that the 24 hour waits that are the average north of the border would not be acceptable to me.
You could get help for the severe cases for Medicaid simply by noting that for purposes of estimating wealth, the first $100k (or whatever) of your home's value and first $x of your retirement accounts are off limits. Probably six pages instead of 2700,tho.
Bonus if you double the size of the bill and equalize tax treatment for self paid and employer and require those who pay for insurance to provide an equivalent amount (or large portion of that) for those who wish to maintain their own coverage.
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